January / December #11 : See Span - by Tim Horn

POZ - Health, Life and HIV
Subscribe to:
POZ magazine
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr MySpace
POZ Personals
Sign In / Join

Back to home » Archives » POZ Magazine issues

Table of Contents

Network News

1995 POZ Honors

1995 POZ Honors: It's An Ad World

1995 POZ Honors: Role Models

1995 POZ Honors: Pope Innocent He's Not

1995 POZ Honors: Arts

1995 POZ Honors: Foreign Affairs

1995 POZ Honors: Hollywood

1995 POZ Honors: Law

1995 POZ Honors: Media

1995 POZ Honors: Movies

1995 POZ Honors: Politics

1995 POZ Honors: Research

1995 POZ Honors: Eating Your Young

Baseball, Hotdogs, Apple Pie and HIV

Hollywood Shuffles AIDS

The Newest AIDS Treatment Is Not a Drug

Banned in the U.S.A.

Mind Over Health Matters

Party Planner

Industrial Strength

Prosper, and Live Long

Worse Things He Could Do

Get Bothered

Health Insured?

See Span


Health Insured

Rhymes and Reason, Too

X-ray Visions

A Little Personal Attention

Symptoms? Persist!

See Span

Butter's Not All Bad

Pas de Deux

C'mon and Celebrate

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

email print

January / December 1996

See Span

by Tim Horn

Can oral ganciclovir prevent vision loss?

For many PWAs—especially those with infectious caused by cytomegalovirus (CMV)—the Food and Drug Administration’s (FDA) decision to approve an oral version of the anti-CMV drug Cytovene (ganciclovir) at the beginning of this year was a blessing.

CMV, a member of the herpesvirus family, can cause a variety of infections, including blindness and life-threatening disease. The only two treatments approved had been Cytovene or Foscavir (foscarnet), which requires daily IV infusions, usually for the rest of a patient’s life. With FDA approval, it became possible to complete a short length of IV therapy and then switch to an oral dose of 12 capsules a day.

Even more exciting was the possibility that oral Cytovene could be used as a preventive drug (prophylaxis) against CMV infection; two clinical trials were conducted. The results of one were presented in October 1994 with much fanfare as a medical break-through in preventive medicine. But the results of the second trial delivered a sobering blow to physicians, researchers and activists.

So which study is correct? Before we pull the plug on CMV prophylaxis, it is important to understand the differences between the two trials. The first, sponsored by Cytovene manufacturer Syntex Laboratories, held that the oral drug was effective. In this study, 725 participants were given either oral Cytovene or placebo. Of the 486 participants on oral Cytovene, only 16 percent developed a form of CMV disease, whereas 30 percent on placebo did. What’s more, only 11 percent of those on Cytovene compared to 20 percent of those on placebo developed sight problems form CMV retinitis.

With this good news, all eyes were fixed on another study being conducted by the Community Programs for Clinical Research on AIDS (CPCRA). This study was anything but reassuring. According t researcher Carol Brosgart, M.D., there was no statistical difference between those on oral Cytovene and those on placebo.

Without disparaging the findings of either research team, it is important to understand that the trials—while similar in their randomized, placebo-controlled design—differed significantly in their overall structure.

What difference does this make? “A world of difference,” says Kevin Frost of the American Foundation for Aids Research. First of all, due to the findings of the Syntex study, the CPCRA was required to offer Cytovene to all participants half-way through their study. The switch-over seriously altered the so-called power of the trial in terms of yielding statistically significant results. “Also,” Frost says, “because CMV retinitis usually doesn’t set in until patients fall below 10 CD4 cells, the participants in the Syntex study were much easier to monitor.”

More important, participants in the Syntex study were monitored carefully by ophthalmologists, whereas those in the CPCRA study were monitored by primary physicians. The difference? Frost concludes, “Because symptoms of CMV retinitis may not manifest themselves until after CMV has caused extensive eye damage, the CPCRAA study did not follow participants long enough to demonstrate the effectiveness of oral Cytovene based on symptoms.”

Where do we go from here? According to ophthalmologist Ronni M. Lieberman, M.D., a conclusion that can be drawn from both trials is the importance of ophthalmologic care for PWAs with fewer than 50 CD4 cells. “There is much to be gained from detecting CMV retinitis in its early stages, especially in the absence of symptoms.”

Scroll down to comment on this story.


(will display; 2-50 characters)


(will NOT display)


(will display; optional)

Comment (500 characters left):

(Note: The POZ team reviews all comments before they are posted. Please do not include either ":" or "@" in your comment. The opinions expressed by people providing comments are theirs alone. They do not necessarily reflect the opinions of Smart + Strong, which is not responsible for the accuracy of any of the information supplied by people providing comments.)

Comments require captcha.
Please enter this number for verification:

| Posting Rules

Show comments (0 total)

[Go to top]

Facebook Twitter Google+ MySpace YouTube Tumblr Flickr Instagram
Quick Links
Current Issue

HIV Testing
Safer Sex
Find a Date
Newly Diagnosed
HIV 101
Disclosing Your Status
Starting Treatment
Help Paying for Meds
Search for the Cure
POZ Stories
POZ Opinion
POZ Exclusives
Read the Blogs
Visit the Forums
Job Listings
Events Calendar
POZ on Twitter

Ask POZ Pharmacist

Talk to Us
Did you participate in an event for National Black HIV/AIDS Awareness Day 2016?


more surveys
Contact Us
We welcome your comments!
[ about Smart + Strong | about POZ | POZ advisory board | partner links | advertising policy | advertise/contact us | site map]
© 2016 Smart + Strong. All Rights Reserved. Terms of use and Your privacy.
Smart + Strong® is a registered trademark of CDM Publishing, LLC.